Outcomes Of Inguinal Hernia Repair Research Articles

The impact of smoking on inguinal hernia repair outcomes: a meta-analysis of multivariable-adjusted studies.

While the detrimental effects of smoking on postoperative outcomes are recognized, the extent of its risk for inguinal hernia repair remains unclear. Our study aims to assess the influence of smoking on patients who undergo inguinal hernia repair. We systematically reviewed PubMed, Embase, and Cochrane databases. Our goal was to identify studies that compared postoperative outcomes in smoking and non-smoking patients after inguinal hernia repair, and which employed a multivariate analysis to reduce possible confounding factors. Outcomes were recurrence, postoperative complications, and surgical site infection. Odds ratios (ORs) with 95% confidence intervals (CIs) were computed with the use of a random-effects model. Heterogeneity was examined with I2 statistics. This review was prospectively registered in PROSPERO (CRD42023445513). Our analysis encompassed 11 studies, involving a total of 577,901 patients. Of these, 77,226 (or 13.4%) identified as smokers, with males constituting 90% of the cohort. In terms of surgical approaches, 58% underwent laparoscopic procedures were most common at 58%, followed by open surgeries at 41%, and 1% used robotic techniques. All included studies had a low risk of bias. Smoking was associated with a higher incidence of hernia recurrence (OR 2.95; 95% CI 2.08 to 4.18; p < 0.001; I2 = 0%). No differences were found in postoperative complication (OR 1.15; 95% CI 1.00 to 1.32; p = 0.05; I2 = 56%) or surgical site infection (OR 2.94; 95% CI 0.80 to 10.88; p = 0.11; I2 = 79%). Smoking was associated with a three-fold increase in recurrence. Further studies are needed to evaluate the impact of preoperative smoking cessation on reducing recurrence.

Evaluation of Long-term Performance of the GORE SYNECOR Intraperitoneal Biomaterial in the Treatment of Inguinal Hernias.

The objective of this study was to analyze device safety and clinical outcomes of inguinal hernia repair with the GORE SYNECOR Intraperitoneal Biomaterial device, a hybrid composite mesh. This retrospective case review analyzed device/procedure endpoints beyond 1 year in patients treated for inguinal hernia repair with the device. Three objectives were evaluated: procedural endpoint-incidence through 30 days of surgical site infection, surgical site occurrence (SSO), ileus, readmission, reoperation, and death; device endpoint-serious device incidence of mesh erosion, infection, excision/removal, exposure, migration, shrinkage, device-related bowel obstruction and fistula, and hernia recurrence through 12 months; and patient-reported outcomes of the bulge, physical symptoms, and pain. A total of 157 patients (mean age: 67±13y) with 201 inguinal hernias (mean size: 5.1±5cm 2 ) were included. Laparoscopic approach and bridging repair were performed in 99.4% of patients. All device location was preperitoneal. No procedure-related adverse events within 30 days were reported. No surgical site infection or SSO events or device-related hernia recurrence occurred through 12 months. Procedure-related serious adverse events occurred in 6 patients; 5 recurrent inguinal hernias (at 1 and 2y) and 1 scrotal hematoma (at 6mo). Through 24 months, no SSO events requiring procedural intervention occurred. Through 50 months, 6 (2.98%) patients had confirmed hernia recurrence and 4 (1.99%) patients had hernia reoperation. The patient-reported outcome for pain was reported by 7.9% (10/126) of patients who completed the questionnaire. In this study, inguinal hernia repair with the hybrid composite mesh was successful in most patients and the rate of recurrence was low, further supporting the long-term safety and device performance.

AN OBSERVATION ON DESARDA TECHNIQUE OF INGUINAL HERNIA REPAIR

Background: Inguinal hernia repair is one of the most commonly performed procedure in surgical practice throughout the world. The non-mesh repair technique of inguinal hernia by Mohan P. Desarda is becoming popular nowadays. Study of the outcomes of the procedure and comparison with other workers is desirable for wider acceptance of the procedure. To study the Objective: outcomes of inguinal hernia repair by Desarda technique. This is an observational study of 32 patients with inguinal hernia repair by Desarda techn Methodology: ique carried out in Dept. of general surgery, Patna Medical College and Hospital, Patna from October 2020 to October 2022. Out of 32 patients included in the study 18 Result: right sided,12 left sided and 2 bilateral inguinal hernia was there. The mean age of study population was 42.72±12.137 years. Mean operating time was found to be 60.81±10.91 minutes. Majority (87.5%) of the patients experienced moderate pain (measured by VAS ) on the rst post-operative day which gradually decreased with the time. Different postoperative complications ; hematoma in 1 patient (3.125%), seroma in 2 patients (6.25%), surgical site infection in 1 patient (3.125%), scrotal swelling in 2 patients (6.125%) and cord swelling in 1 patient (3.125%) were seen. Conclusion: Non mesh Desarda repair of inguinal hernia repair is associated with less operating time, early ambulation, less post operative pain and complication. As it doesn't use mesh so it is cost effective also and should denitely be encouraged.

The effect of smoking status on inguinal hernia repair outcomes: An ACHQC analysis.

Smoking has been shown to negatively affect surgical outcomes, so smoking cessation prior to elective operations is often recommended. However, the effects of smoking status on inguinal hernia repair outcomes have not been extensively studied. Hence, we investigated the association between smoking status and short-term adverse outcomes following inguinal hernia repair. Abdominal Core Health Quality Collaborative database was queried for elective, clean inguinal hernia repairs, excluding those with concomitant procedures or where length of stay > 30days. The resulting cohort was divided into three groups: current smokers, former smokers, and never smokers. Baseline patient, hernia, operative characteristics, and 30-day outcomes were compared. Multivariable logistic regression was used to evaluate the association between smoking status and overall and wound complications. 19,866 inguinal hernia repairs were included (current smokers = 2239, former smokers = 4064 and never smokers = 13,563). Current smokers and former smokers, compared to never smokers, had slightly higher unadjusted rates of overall complication rates (9% and 9% versus 7%, p = 0.003) and surgical site occurrences/infection (6% and 6% versus 4%, p < 0.001). However, on multivariable analysis, compared to current smokers, neither the rates of overall complications nor surgical site occurrences were significantly different in former smokers (OR = 0.93, 95% CI [0.76, 1.13] and OR = 0.92, 95% CI [0.73, 1.17]) and never smokers (OR = 0.99, 95% CI [0.83, 1.18] and OR = 0.86, 95% CI [0.70,1.06]) respectively. Smoking status is not associated with short-term adverse outcomes following inguinal hernia repair. Mandating smoking cessation does not appear necessary to prevent short-term adverse outcomes.

Risk Factor And Outcome Of Inguinal Hernia Repair Under Local Anesthesia Among Elderly Patients

Risk Factor And Outcome Of Inguinal Hernia Repair Under Local Anesthesia Among Elderly Patients

Laparoscopic and robotic inguinal hernia repair are safe and effective after prior pelvic or low abdominal surgery

BackgroundThe ideal approach to inguinal hernia repair (IHR) after prior pelvic or low abdominal surgery is not agreed upon. We compared safety and outcomes of IHR between open, laparoscopic, and robotic approaches. MethodsThis retrospective review of a prospective database analyzed demographic, perioperative, and quality of life data for patients who underwent IHR after pelvic or low abdominal surgery. Results286 qualifying patients underwent IHR between 2008 and 2020; 119 open, 147 laparoscopic, and 20 robotic. Laparoscopic repair led to faster cessation of narcotics and return to ADLs than open repair (all p <0.05). Post-operative complications, 30-day readmission, recurrences, and quality of life outcomes were equivalent, except less pain at 3-weeks post-op in the minimally invasive groups, p < 0.01. ConclusionMinimally invasive IHR after prior pelvic or low abdominal surgery is safe compared to an open approach. Laparoscopic repair provides faster recovery, yet patient satisfaction is equivalent regardless of surgical approach.

A step towards Lichtenstein repair as a day care surgery: spinal versus local anaesthesia

Background: Inguinal hernia repair includes 15% of the procedures in general surgery. Until now the conventional post-operative protocol was to keep patient admitted till the patient was completely mobilized and fit to return to daily activity. This leads to unnecessary occupancy of hospital beds and increased financial burden to the patients. Therefore, day care surgery or short stay surgery is the need of the hour, in which local anaesthesia can play a major part. The aim of this study was to analyse the outcomes of inguinal hernia repair with special emphasis on the use of local and spinal anaesthesia and to find out which among the two was regarded as an effective method.Methods: A randomised control trial was conducted at MGM medical hospital, Aurangabad over a duration of two years (November 2016 to October 2018) where 100 patients of uncomplicated unilateral inguinal hernia were included. 50 patients were given spinal anaesthesia and 50 patients were given local anaesthesia. Intra-operative and post-operative complications and recovery was noted.Results: The duration of surgery, post-operative pain and complications were significantly lesser in local anaesthesia group (p&lt;0.0001). Post-operative mobilisation, micturition and starting of oral diet was significantly earlier in patients receiving local anaesthesia (p&lt;0.0001). The patients in the local anaesthesia group were discharged sooner than the spinal anaesthesia group (p&lt;0.0001).Conclusions: Thus, local anaesthesia has a major role in establishing inguinal hernia repair as a day care or short stay surgery. Local anaesthesia is a safe, efficient and cost-effective option for inguinal hernia repair compared to spinal anaesthesia in terms of patient benefits and patient satisfaction.

To compare the outcome of inguinal hernia repair under local and spinal anesthesia

INTRODUCTION: The most frequent form of hernia is inguinal hernia, affecting around 15% of adult males. The optimal surgical anesthetic method for ambulatory inguinal hernia repair is unknown at the moment, and there is no consensus on the procedure. The goal of this study was to examine the outcome of inguinal hernia repair under local anesthesia compared with spinal anesthesia. MATERIALS AND METHODS: In this prospective observational study, 80 patients were randomly assigned into two groups by the SNOSE method with a different mode of anesthesia: group SA (n = 40) and group LA (n = 40). Lichtenstein tension-free hernioplasty was done in all patients. Pre- and post-OP clinical examinations (3rd day) were looked for complications. RESULTS: There were no significant demographic differences between the two groups. When compared with the SA group, the LA group experienced much less post-operative pain. With local anesthesia, post-operative ambulation was substantially faster. The use of a local anesthetic allowed for a shorter stay in the hospital and a speedy return to regular activity. In general, local anesthesia was linked to less post-operative complications in the early aftermath. CONCLUSION: Local anesthesia is a preferable choice to spinal anesthesia for short stay or daycare surgery, particularly for patients who are unable to tolerate spinal anesthesia. As a result, Lichtenstein’s hernioplasty performed under local anesthesia is attracting considerable interests in the field of groin hernia repair.

Outcome of inguinal hernia repair after previous radical prostatectomy: a registry-based analysis with 12,465 patients

IntroductionFollowing radical prostatectomy, the rate of inguinal hernias is fourfold higher compared to controls. Laparo-endoscopic repair after previous radical prostatectomy is considered complex. Therefore, the guidelines recommend open Lichtenstein repair. To date, there are limited data on inguinal hernia repair after prior prostatectomy.MethodsIn a retrospective analysis from the Herniamed Registry, the outcomes of 255,182 primary elective unilateral inguinal hernia repairs were compared with those of 12,465 patients with previous radical prostatectomy in relation to the surgical technique. Furthermore, the outcomes of laparo-endoscopic versus open Lichtenstein repair techniques in the 12,465 patients after previous radical prostatectomy were directly compared.ResultsComparison of the perioperative complication rates for primary elective unilateral inguinal hernia repair with and without previous radical prostatectomy demonstrated for the laparo-endoscopic techniques significantly higher intraoperative complications (2.1% vs 0.9%; p < 0.001), postoperative complications (3.2% vs 1.9%; p < 0.001) and complication-related reoperations (1.1% vs 0.7%; p = 0.0442) to the disadvantage of previous prostatectomy. No significant differences were identified for Lichtenstein repair. Direct comparison of the laparo-endoscopic with the open Lichtenstein technique for inguinal hernia repair after previous radical prostatectomy revealed significantly more intraoperative complications for TEP and TAPP (2.1% vs 0.6%; p < 0.001), but more postoperative complications (4.8% vs 3.2%; p < 0.001) and complication-related reoperations (1.8% vs 1.1%; p = 0.003) for open Lichtenstein repair.ConclusionSince there are no clear advantages for the laparo-endoscopic vs the open Lichtenstein technique in inguinal hernia repair after previous radical prostatectomy, the surgeon can opt for one or the other technique in accordance with their experience.

Comparison between TAPP & Lichtenstein techniques for inguinal hernia repair: A retrospective cohort study

BackgroundWorldwide, inguinal hernia repair is one of the commonest surgeries. The best treatment option to primary hernia has been investigated, but there still remains lack of evidence about the ideal approach. Therefore, this study aimed to compare the outcomes of inguinal hernia repair using transabdominal preperitoneal procedure (TAPP) & Lichtenstein techniques. Materials and methodsThis was a retrospective cohort study, conducted at Department of General & Minimal Invasive Surgery, SKIMS Medical College, Bemina, Srinagar. For performing the analysis, we used SPSS. Continuous variables were expressed as mean and standard deviation, and the categorical ones were presented as frequencies and percentages. ResultsA total of 60 patients were included (30 in each group). The mean age of the patients in both groups was around 54 years, and all patients were males. In unilateral cases the operating time was greater in the TAPP group than the Lichtenstein group (p < 0.001); however, in the bilateral cases, the operating time was significantly greater in the Lichtenstein than the TAPP group (p = 0.003). The pain scores, in unilateral cases, were significantly lower in the TAPP group than the Lichtenstein group (p < 0.001). The overall complication rate in the TAPP group was 6.7% while in the Lichtenstein group it was at 23.3%. In unilateral and bilateral cases, the patients significantly returned to work earlier in the TAPP group than those in the Lichtenstein group (p < 0.001). ConclusionTAPP and Lichtenstein techniques are both safe and reliable techniques for inguinal hernia repair. However, TAPP repair showed lesser post-operative pain, earlier discharge from the hospital, earlier return to usual activities, better cosmetic outcomes, and less persisting pain. However, there was no significant difference in the complication rate and TAPP repair was more costly for the patient.

Short-Term Outcomes of Inguinal Hernia Repair in Older Patients: A Retrospective Review at a Tertiary Center.

ObjectivesAlthough inguinal hernia (IH) repair is low-risk surgery, older patients are occasionally offered watchful waiting because of their functional status and comorbidities. This study reviewed the surgical outcomes of IH repair in older patients in comparison with outcomes in younger patients.MethodsThis retrospective study included all patients who had IH repair from 2010 to 2020. The primary outcomes of interest were postoperative complications and recurrence.ResultsA total of 262 patients underwent IH repair during the study period; 40% were ≥60 years old. One patient had a recurrence. Among the 8% of patients who had postoperative complications, groin pain was the most common one (1.9%). Female patients had a significantly higher rate of complications than male patients did (38.5% female versus 6.4% male, p<0.001). The rate of complications was also higher for emergency surgery than for elective surgery (22.6% emergency versus 6.1% elective, p<0.001), as well for patients who needed concomitant bowel resection compared with those who did not. Patients who had emergency surgery or postoperative complications had a prolonged hospital stay. ConclusionsIH repair in older patients is low-risk surgery, comparable to that in younger patients. In this study, emergency surgery was more common in older than in younger patients and posed a higher risk of complications. We recommend offering elective hernia repair to older patients to avoid the higher complication rate associated with emergency repair.

A Comparative Study of Pediatric Inguinal Hernia Repair by Open Technique versus Laparoscopic Repair

Background: Herniotomy / open surgery has been the time honoured treatment for paediatric inguinal hernia. The improvement of paediatric Laparoscopic hernia and increased experience with Laparoscopic technique become an important skill. Laparoscopic repair of inguinal hernias in children is adopted too quickly, cost effective, cosmetically, less invasive, more feasible and less painful. This procedure is that, it could allow contralateral hernia detection and repair in same setting. Aims and objectives: In our study we aimed to compare between the outcome of inguinal hernia repair in two study group open hernia repair and Laparoscopic hernia repair by Z suture or purse string technique and study to the early and late complication. Materials and methods: the current prospective study carried out in Department of General Surgery, SVBP Hospital Meerut which included 40 patients duration of period from September 2018 to September 2019. Among them, 20 patients in group 1 were repaired by Open procedure and another 20 patients in group 2 were repaired by Laparoscopic procedure. Results: The study included 40 patients. The mean time of operation in Laparoscopic repair (41.50 minute) is slightly shorter than that of open repair (47.50 minute) technique. Postoperative pain was much less in LH group then open hernia group. Hospital stay in LH (1.55 days) and in OH (2.20 days). Oral ships were allowed and well tolerated as early in LH (7.3 hrs) and in OH (10.90 hrs), this was statistically significant. Patients financial satisfaction was lower in group 2than in group 1 repair. Conclusion: The data from study confirmed that the results of Laparoscopic technique has advantage of reduced postoperative pain, diagnosis of CPPV with its management in the same sitting, rapid return to everyday activities, better cosmetic results, cost effective, more feasible and less painful.

Feasibility, safety and outcome of inguinal hernia repair under spinal versus general anesthesia in preterm and term infants

BackgroundInguinal hernia repair (IHR) is a common operation in preterm and term infants. Recently, spinal anesthesia (SA) has been proposed as an alternative to avoid exposure to general anesthesia (GA) during early life. The aim of this study was to compare surgical outcomes of open IHR performed under SA versus GA in neonates and infants, and to detect criteria to predict the success or failure of SA. Materials and methodsThis is a 6-year, single center, nonrandomized interventional study (2013–2019). SA was performed with 0.5% bupivacaine. GA was given using propofol, fentanyl, sevoflurane, and laryngeal mask. Patient demographics, operative time, intraoperative events related to surgery or anesthesia, and complications were analyzed at short and long-term follow-up. Results68 infants (78 IHR) and 37 infants (44 IHR) received SA and GA at the discretion of the anesthesiologist, respectively. SA failure rate was 9%, and positively correlated with weight at surgery (p = 0.001; rp = 0.38). Conversion from SA to GA occurred in 4 (6%) patients owing to prolonged operative time (43.75 ± 4.8 vs 23.02 ± 11.3 min; p = 0.0006). There were no differences regarding operative time and intra- and postoperative complications among the two groups at mean follow-up of 18.53 ± 21.9 months. ConclusionsThis pilot study confirms that SA is safe, effective and not detrimental to surgical outcome of neonates and infants undergoing IHR. Additionally, it may help further define what patients may have a successful SA. Our experience suggests that SA is especially suitable in infants weighing <4000 g, and conversion to GA correlates with prolonged operative time. Level of evidenceLevel II.

Open inguinal hernia repair outcomes in liver transplant recipients versus patients with cirrhosis

Patients with liver cirrhosis (LC) are at an increased risk for postoperative complications after open inguinal hernia repair (OIHR). It is possible that orthotopic liver transplant (OLT) recipients may have better outcomes, given reversal of liver failure pathophysiology. Therefore, we sought to compare mortality risk, complications, length of stay (LOS), and cost associated with OIHR in OLT recipients versus LC. From the National Inpatient Sample (NIS), using ICD-9 codes, we found 83 OLT recipients and 764 patients with LC who underwent OIHR between 2002 and 2014. We used logistic, negative binomial, and multiple linear regression models to compare peri-operative mortality risk, postoperative complications, and LOS, and cost associated with OIHR in OLT recipients versus LC patients. Models were adjusted for patient demographic and clinical characteristics, and hospital factors. OLT recipients were younger (58 vs 61, p = 0.02), more likely to be privately insured (42.0% vs 24.6%, p = 0.006), less likely to have ascites at time of surgery (5.1% vs 18.9%, p = 0.003), and have surgery at large (84.3% vs 65.2%, p = 0.01) and teaching hospitals (84.2% vs 47.9%, p < 0.001). There were no mortalities among OLT recipients, but 19 (2.5%) deaths among LC patients. OLT recipients had a similar risk of overall complications (adjusted odds ratio aOR = 0.71 1.30 2.41) and hospital-associated costs (adjusted cost ratio = 0.71 0.88 1.09). However, LOS was significantly different with OLT recipients having shorter LOS (adjusted LOS ratio = 0.56 0.70 0.89). Delaying OIHR in patients with LC until after OLT decreases LOS and may carry decreased mortality.

Outcomes of inguinal hernia repair in cirrhotics: a single tertiary centre experience

Patients with liver cirrhosis are at a higher risk of perioperative anaesthetic and surgical complications. Surgical repair of abdominal wall hernias in these patients has been widely discouraged. The main objective of this study was to evaluate the post-operative outcomes of patients with liver cirrhosis after inguinal hernia repair at a single institution. A retrospective review of a prospectively maintained database of 31 patients with liver cirrhosis undergoing inguinal hernia repair between 2006 and 2016 was undertaken. Data in relation to patient demographics, clinicopathological characteristics, morbidity and mortality were collected. Thirty-one patients with median Model for End-stage Liver Disease score of 14 (7-36) underwent inguinal hernia repair within a 10-year period of our study. There was one mortality in a patient with Model for End-stage Liver Disease score of 36 who presented with a strangulated hernia. Only one patient required return to theatre for the evacuation of haematoma and one patient developed a recurrent hernia in 1-year follow up. Inguinal hernia repair in patients with cirrhosis is a safe procedure to perform in the elective setting. Nevertheless, significant consideration must be given in performing these operations in centres with liver transplant units due to their extensive experience in pre-operative optimization to reduce the risk of hepatic decompensation.

Robotic Inguinal Hernia Repair Outcomes: Operative Time and Cost Analysis.

Background:Robotic inguinal hernia repair is the latest iteration of minimally invasive herniorrhaphy. Previous studies have shown expedited learning curves compared to traditional laparoscopy, which may be offset by higher cost and longer operative time. We sought to compare operative time and direct cost across the evolving surgical practice of 10 surgeons in our healthcare system.Methods:This is a retrospective review of all transabdominal preperitoneal robotic inguinal hernia repairs performed by 10 general surgeons from July 2015 to September 2018. Patients requiring conversion to an open procedure or undergoing simultaneous procedures were excluded. The data was divided to compare each surgeon’s initial 20 cases to their subsequent cases. Direct operative cost was calculated based on the sum of supplies used intra-operatively. Multivariate analysis, using a generalized estimating equation, was adjusted for laterality and resident involvement to evaluate outcomes.Results:Robotic inguinal hernia repairs were divided into two groups: early experience (n = 167) and late experience (n = 262). The late experience had a shorter mean operative time by 17.6 min (confidence interval: 4.06 – 31.13, p = 0.011), a lower mean direct operative cost by $538.17 (confidence interval: 307.14 – 769.20, p < 0.0001), and fewer postoperative complications (p = 0.030) on multivariate analysis. Thirty-day readmission rates were similar between both groups.Conclusion:Increasing surgeon experience with robotic inguinal hernia repair is associated with a predictable reduction in operative time, complication rates, and direct operative cost per case. Thirty-day readmission rates are not affected by the learning curve.

Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.&#x0D; Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.&#x0D; Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.&#x0D; Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).&#x0D; Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

Repair of inguinal hernia by Desarda technique in both elective and emergency setting

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.&#x0D; Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.&#x0D; Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.&#x0D; Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).&#x0D; Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

Safety and effectiveness of inguinal hernia repair in patients with liver cirrhosis: a retrospective study and literature review.

Inguinal hernia is a common feature of decompensated liver cirrhosis and a frequent cause of life-threatening complications. The traditional treatment of inguinal hernia in patients with liver cirrhosis includes non-operative management; however, emerging data suggest elective surgical repair as a preferable approach. Therefore, we aimed to assess the outcomes of inguinal hernia repair in patients with liver cirrhosis and describe their clinical characteristics. In this retrospective study, we included a total of 28 consecutive patients with liver cirrhosis who underwent inguinal hernia repair between March 2000 and May 2019 at the First People's Hospital of Xiaoshan, Hangzhou, China. We also reviewed the literature on inguinal hernia repair in patients with liver cirrhosis. Emergency surgery for complicated hernia was performed in 17.9% of the study patients. Two patients developed major complications including wound hematoma in 1, who required reoperation, and gastrointestinal tract hemorrhage in the other patient, who required blood transfusion. Further, minor complications developed in 6 patients, including wound seroma in 1 and scrotal swelling in 5. Emergency hernia repair was found to be associated with a higher complication rate than elective surgery in patients with liver cirrhosis. Elective surgery for inguinal hernia repair in patients with liver cirrhosis appears to be successful and might be associated with a lower complication rate than emergency surgery. Inguinal hernia repair is recommended for patients with liver cirrhosis to prevent the development of life-threatening complications.

Early Outcome of Lichtenstein Technique for Inguinal Hernia Repair in Tertiary Care Hospital

Background: Inguinal hernia repair are very common in day to day general surgical practice. Results of surgical repair are often satisfactory but recurrences following surgery is troublesome both for surgeon and patient. Lichtenstein technique is now the most widely performed technique in groin hernia repair. The aim of this study was to assess short term outcome of inguinal hernia repair by Lichtenstein technique.&#x0D; Methods and materials: In this prospective study, 30 inguinal hernia repairs were performed by Lichtenstein technique between January 2015 and December 2017 in surgery department of Holy Family Red Crescent Medical College Hospital. Patients were scheduled for follow up visits at 1st week, three months and six months in out- patient department. The main outcome measure was early recurrence, groin pain and other complications.&#x0D; Results: In this study age of the patients ranged from 30 years to 78 years, The mean age was 51.93 (±SD 10.12) years. Regarding personal habit, more than half of the patients of inguinal hernia were found to be non-smoker and about 37% of the patients were current smokers. Most of the hernia were of indirect type (18/30) followed by direct type (9/30). In indirect type 55.6% of the hernias were in the right side and the rest were in left side. On an average each operation lasted for 1.18 hours and oral feeding started 12.69 hours after the operation. Two patients (6.7%) had a prolonged recovery and presented with abdominal distention after operation. Postoperative hospital stay that was 2.27 days. 6 (20%) patients developed postoperative urinary retention. Scrotal haematoma formation was observed in 5(17%) cases and local haematoma or seroma formation in incision site was reported in 4 (13%) cases. In 6 patients (20%) we used suction drain tube at tissue plane where mesh was placed for draining of blood or seroma and that drain tube was removed 2nd or 3rd postoperative period. Periincisional skin echymosis, abdominal distension and superficial wound infection, postoperative pyrexia were the other complications reported. No recurrence or mesh rejection or mesh infection were observed within short time postoperative follow up period.&#x0D; Conclusion: Lichtenstein technique is easy to learn, simple to perform and very rationale to perform and recurrence rate is low. Multi-centre studies with larger sample and longer duration of study and more sound study design could bring more insight regarding this issue.&#x0D; Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 62-69